José María León Rubio

Efficacy and safety of acupuncture for chronic uncomplicated neck pain: A randomised controlled study☆

&NA; Chronic neck pain is highly prevalent. To determine the efficacy and safety of acupuncture, in comparison with transcutaneous nerve stimulation‐placebo (TENS‐placebo) in the treatment of chronic uncomplicated neck pain, a single blind prospective study was designed, to be carried out at a Primary Healthcare Centre, with random assignment to two parallel groups and with evaluation and analysis by independent evaluators. A random assignment was made from 123 patients of the 149 initially recruited. These patients had been diagnosed with uncomplicated neck pain and experienced neck motion‐related pain intensity equal to or exceeding 30 on a visual analogue scale (VAS) from 0 to 100 mm. The treatment with acupuncture was compared with TENS‐placebo, applied over 5 sessions in three weeks. The primary endpoint was the change in maximum pain intensity related to motion of the neck, one week after the final treatment. Sensitivity was analysed per protocol (PP) and variant analyses were by intention to treat (ITT). Adjustment was made for confounders by multiple linear regression, including baseline values and rescue therapy. By ITT analysis, the change in the pain‐VAS variable was greater among the experimental group (28.1 (95% CI 21.4–34.7)). The improvements in quality of life (physical aspect), active neck mobility and reduced rescue medication were clinically and statistically significant. In the treatment of the intensity of chronic neck pain, acupuncture is more effective than the placebo treatment and presents a safety profile making it suitable for routine use in clinical practice.

A pragmatic guideline for evaluation of social intervention.

Considering the many theoretical and methodological viewpoints in the field of evaluation, a guideline was established to facilitate the evaluation of social intervention programs. For this purpose, the goals of the evaluation were taken into account: (a) planning interventions, (b) learning and continuous improvement of interventions, (c) programming policies, and (d) transformation of society. These goals will determine the perspective of the analysis selected (focusing on the evaluand or the context) and the strategies for change employed (focusing on processes or results). The elements that, according to Shadish, Cook, and Levinton (1991), constitute the theory of evaluation (evaluand, value, building of knowledge, and uses) have also been considered. The analysis of all these components led to the elaboration of a guideline to orient the practice of evaluation from a pragmatic perspective, in accordance with the demands and needs of a certain social context.

Contrastación experimental de las teorías del drive o impulso de la facilitación social

ResumenEn las ultimas tres decadas la Facilitacion Social ha llevado a los investigadores al desarrollo de un buen numero de diferentes teorias que han tratado de dar cuenta del fenomeno psicosocial mas basico. A pesar de esta prolijidad teorica carecemos de una explicacion satisfactoria de este. Ademas, el contraste experimental de las diferentes hipotesis, que seria enormemente clarificador, no ha sido nunca llevado a efecto. Por consiguiente el objetivo principal de este trabajo ha sido disenar una situacion experimental adecuada que intetara clarificar los graves problemas teoricos y metodologicos que rodean a la Facilitacion Social. Utilizando un diseno experimental mixto (6×2) pudimos contrastar simultaneamente las principales teorias sobre la Facilitacion Social (hipotesis del drive). En relacion con los mencionados problemas teoricos y metodologicos, fue necesario una definicion rigurosa del arousal (como un patron multidimensional integrado de diferentes parametros psicofisiologicos) y de los gru...